Effect of early risedronate treatment on bone mineral density and bone turnover markers after liver transplantation: a prospective single-center study

Transpl Int. 2011 Jul;24(7):657-65. doi: 10.1111/j.1432-2277.2011.01253.x. Epub 2011 Apr 5.

Abstract

The aim of this study was to investigate the effect of risedronate (RIS) on bone loss and bone turnover markers after liver transplantation (LT). Patients with osteopenia or osteoporosis within the first month after LT were randomized to receive RIS 35 mg/week plus calcium 1000 mg/day and vitamin D(3) 800 IU/day (n = 45) or calcium and vitamin D(3) at same dosages (n = 44). Primary endpoint was change in bone mineral density (BMD) 6 and 12 months after LT. Secondary endpoints included changes in serum β-CrossLaps (β-CTX) and procollagen type 1 amino-terminal peptide (P1NP) and fracture rate. Spine X-rays were obtained at baseline and after 12 months. There was no significant difference in BMD changes between both treatment groups at any sites; either at 6 or 12 months. Spine BMD increased in both groups at 12 months vs. baseline (P = 0.001). RIS patients had a significant increase in intertrochanteric BMD at 12 months (P < 0.05 vs. baseline). Serum β-CTX decreased in both groups (P < 0.01), with significant differences between groups at 3 months. No significant difference in vertebral fracture incidence was found. After 12 months, BMD improved at lumbar spine and did not change at hip in both groups. Significant differences between both groups were not found. Other factors (calcium and vitamin D replacement, early prednisone withdrawal) seem to have also positive effects in BMD.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Density / drug effects*
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Remodeling / drug effects*
  • Calcium / therapeutic use
  • Cholecalciferol / therapeutic use
  • Etidronic Acid / analogs & derivatives*
  • Etidronic Acid / therapeutic use
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postmenopause
  • Prospective Studies
  • Risedronic Acid
  • Spinal Fractures / prevention & control

Substances

  • Bone Density Conservation Agents
  • Cholecalciferol
  • Risedronic Acid
  • Etidronic Acid
  • Calcium